Ishihara S, Ohshima K, Tokura Y, Yabuta R, Imaishi H, Wakiguchi H, Kurashige T, Kishimoto H, Katayama I, Okada S, Kawa-Ha K
Section of Pediatrics, Kashiwara Municipal Hospital, Osaka.
Jpn J Cancer Res. 1997 Jan;88(1):82-7. doi: 10.1111/j.1349-7006.1997.tb00305.x.
In order to clarify the relationship between Epstein-Barr (EB) virus and hypersensitivity to mosquito bites (HMB), and to search for the mechanism which induces EB virus-associated lymphoproliferative diseases, we investigated patients with HMB, using hematological, immunological and virological techniques. Among 5 cases of HMB, CD56+ cells had proliferated and CD3+ cells were diminished in 4 cases. Although anti-EB virus antibody titers were not consistent with chronic active EB virus infection, EB viral DNA was detected in the peripheral blood mononuclear cells in all 5 cases. Moreover, EB viral DNA-positive cells had proliferated monoclonally in 4 cases, and biclonally in 1 case. It was proved that most of the EB viral DNA existed in natural killer (NK) cells through polymerase chain reaction analysis. These findings suggest that the basis of HMB may be clonal lymphoproliferation of EB viral DNA-positive NK cells and this hematological abnormality may induce the characteristic symptoms of HMB. In some cases, the proliferating NK cells can metamorphose into leukemic cells, and hemophagocytic syndrome, which has been assumed to be a complication of HMB, may then occur.
为了阐明爱泼斯坦-巴尔（EB）病毒与蚊虫叮咬超敏反应（HMB）之间的关系，并寻找诱发EB病毒相关淋巴增殖性疾病的机制，我们运用血液学、免疫学和病毒学技术对HMB患者进行了调查。在5例HMB患者中，4例出现CD56+细胞增殖而CD3+细胞减少。虽然抗EB病毒抗体滴度与慢性活动性EB病毒感染不一致，但所有5例患者的外周血单个核细胞中均检测到EB病毒DNA。此外，4例患者的EB病毒DNA阳性细胞呈单克隆增殖，1例呈双克隆增殖。通过聚合酶链反应分析证实，大部分EB病毒DNA存在于自然杀伤（NK）细胞中。这些发现表明，HMB的基础可能是EB病毒DNA阳性NK细胞的克隆性淋巴增殖，这种血液学异常可能诱发HMB的特征性症状。在某些情况下，增殖的NK细胞可转变为白血病细胞，进而可能发生被认为是HMB并发症的噬血细胞综合征。
